Provider Demographics
NPI:1194998849
Name:HINDERKS, JEREMY STEVEN (DC)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:STEVEN
Last Name:HINDERKS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:RENVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56284-0459
Mailing Address - Country:US
Mailing Address - Phone:320-329-8185
Mailing Address - Fax:320-329-8186
Practice Address - Street 1:107 DUPONT AVE NW
Practice Address - Street 2:
Practice Address - City:RENVILLE
Practice Address - State:MN
Practice Address - Zip Code:56284-3352
Practice Address - Country:US
Practice Address - Phone:320-329-8185
Practice Address - Fax:320-329-8186
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor